Pulse oximetry adoption and oxygen orders at paediatric admission over 7 years in Kenya: a multihospital retrospective cohort study.
audit
epidemiology
paediatrics
protocols & guidelines
quality in health care
tropical medicine
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
07 09 2021
07 09 2021
Historique:
entrez:
8
9
2021
pubmed:
9
9
2021
medline:
16
9
2021
Statut:
epublish
Résumé
To characterise adoption and explore specific clinical and patient factors that might influence pulse oximetry and oxygen use in low-income and middle-income countries (LMICs) over time; to highlight useful considerations for entities working on programmes to improve access to pulse oximetry and oxygen. A multihospital retrospective cohort study. All admissions (n=132 737) to paediatric wards of 18 purposely selected public hospitals in Kenya that joined a Clinical Information Network (CIN) between March 2014 and December 2020. Pulse oximetry use and oxygen prescription on admission; we performed growth-curve modelling to investigate the association of patient factors with study outcomes over time while adjusting for hospital factors. Overall, pulse oximetry was used in 48.8% (64 722/132 737) of all admission cases. Use rose on average with each month of participation in the CIN (OR: 1.11, 95% CI 1.05 to 1.18) but patterns of adoption were highly variable across hospitals suggesting important factors at hospital level influence use of pulse oximetry. Of those with pulse oximetry measurement, 7% (4510/64 722) had hypoxaemia (SpO The adoption of pulse oximetry recommended in international guidelines for assessing children with severe illness has been slow and erratic, reflecting system and organisational weaknesses. Most oxygen orders at admission seem driven by clinical and situational factors other than the presence of hypoxaemia. Programmes aiming to implement pulse oximetry and oxygen systems will likely need a long-term vision to promote adoption, guideline development and adherence and continuously examine impact.
Identifiants
pubmed: 34493522
pii: bmjopen-2021-050995
doi: 10.1136/bmjopen-2021-050995
pmc: PMC8424839
doi:
Substances chimiques
Oxygen
S88TT14065
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e050995Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Investigateurs
Lynda Isaaka
(L)
George Mbevi
(G)
Cynthia Khaenzi
(C)
Paul Mwaniki
(P)
Mercy Chepkirui
(M)
John Wainaina
(J)
Livingstone Mumelo
(L)
Edith Gicheha
(E)
Monica Musa
(M)
Naomi Muinga
(N)
Muthoni Ogola
(M)
Laura Oyiengo
(L)
Caroline Mwangi
(C)
Fred Were
(F)
Juma Vitalis
(J)
Nyumbile Bonface
(N)
Roselyne Malangachi
(R)
Christine Manyasi
(C)
Catherine Mutinda
(C)
David Kibiwott Kimutai
(DK)
Rukia Aden
(R)
Caren Emadau
(C)
Elizabeth Atieno Jowi
(EA)
Cecilia Muithya
(C)
Charles Nzioki
(C)
Supa Tunje
(S)
Penina Musyoka
(P)
Wagura Mwangi
(W)
Agnes Mithamo
(A)
Magdalene Kuria
(M)
Esther Njiru
(E)
Mwangi Ngina
(M)
Penina Mwangi
(P)
Rachel Inginia
(R)
Melab Musabi
(M)
Emma Namulala
(E)
Grace Ochieng
(G)
Lydia Thuranira
(L)
Felicitas Makokha
(F)
Josephine Ojigo
(J)
Beth Maina
(B)
Catherine Mutinda
(C)
Mary Waiyego
(M)
Bernadette Lusweti
(B)
Angeline Ithondeka
(A)
Julie Barasa
(J)
Meshack Liru
(M)
Elizabeth Kibaru
(E)
Alice Nkirote Nyaribari
(AN)
Joyce Akuka
(J)
Joyce Wangari
(J)
Amilia Ngoda
(A)
Aggrey Nzavaye Emenwa
(AN)
Dolphine Mochache
(D)
Patricia Nafula Wesakania
(PN)
George Lipesa
(G)
Jane Mbungu
(J)
Marystella Mutenyo
(M)
Joyce Mbogho
(J)
Joan Baswetty
(J)
Ann Jambi
(A)
Josephine Aritho
(J)
Beatrice Njambi
(B)
Felisters Mucheke
(F)
Zainab Kioni
(Z)
Lucy Kinyua Jeniffer
(LK)
Margaret Kethi
(M)
Alice Oguda
(A)
Salome Nashimiyu Situma
(SN)
Nancy Gachaja
(N)
Loise N Mwangi
(LN)
Ruth Mwai
(R)
Irginia Wangari Muruga
(IW)
Nancy Mburu
(N)
Celestine Muteshi
(C)
Abigael Bwire
(A)
Salome Okisa Muyale
(SO)
Naomi Situma
(N)
Faith Mueni
(F)
Hellen Mwaura
(H)
Rosemary Mututa
(R)
Caroline Lavu
(C)
Joyce Oketch
(J)
Jane Hore Olum
(JH)
Orina Nyakina
(O)
Faith Njeru
(F)
Rebecca Chelimo
(R)
Margaret Wanjiku Mwaura
(MW)
Ann Wambugu
(A)
Epharus Njeri Mburu
(EN)
Linda Awino Tindi
(LA)
Jane Akumu
(J)
Ruth Otieno
(R)
Slessor Osok
(S)
Seline Kulubi
(S)
Susan Wanjala
(S)
Pauline Njeru
(P)
Rebbecca Mukami Mbogo
(RM)
John Ollongo
(J)
Samuel Soita
(S)
Judith Mirenja
(J)
Mary Nguri
(M)
Margaret Waweru
(M)
Mary Akoth Oruko
(MA)
Jeska Kuya
(J)
Caroline Muthuri
(C)
Esther Muthiani
(E)
Esther Mwangi
(E)
Joseph Nganga
(J)
Benjamin Tanui
(B)
Alfred Wanjau
(A)
Judith Onsongo
(J)
Peter Muigai
(P)
Arnest Namayi
(A)
Elizabeth Kosiom
(E)
Dorcas Cherop
(D)
Faith Marete
(F)
Johanness Simiyu
(J)
Collince Danga
(C)
Arthur Otieno Oyugi
(AO)
Fredrick Keya Okoth
(FK)
Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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